Digir Island is a low-lying coral island in Kuna Yala, a semi-autonomous territory (“comarca”) of Panama. It is a key case of mean sea level rise (MSLR) vulnerability where climatic and man-made pressures- overpopulation, coral mining, and environmental pollution- on coastal and marine ecosystems coincide with low human adaptive capacity. Between 1907-2010 mean seal level (MSL) rose about 0.16 m, or an average of 1.6 mm/yr. Projected future MSLR ranges from 0.2-0.5 m by 2045, a rate three to eight times greater than the historical mean. This leads to the conclusion that the best long-term alternative will be for the population to retreat to the mainland. The most appropriate short-term adaptation includes a combination of increasing awareness in the community, better defining and quantifying the risks of MSLR, implementation of inexpensive wave defenses and sustainability activities to mitigate the effects of MSLR, and planning a relocation program. Better understanding the community’s lifestyle and potential threats from MSLR will enable policy makers to undertake adaptive or mitigating strategies and to minimize potential disruption and costs associated with the perhaps inevitable relocation. The inhabitants of Digir Island rely almost exclusively on the coastal and marine resources around the island. Resources such as housing, coastal and marine habitats (mangroves, coral reefs, sea grasses), subsistence agriculture and fresh water are also likely to be particularly sensitive to future SLR. Rising sea level will exacerbate problems such as food and water scarcity, disease, and socio-cultural pressures. Finally, SLR will jeopardize much of the economic activity on the island, particularly in the fisheries, tourism, and agricultural sectors.